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Efficiency of transcatheter closure of atrial septal defects in small and symptomatic children

Published online by Cambridge University Press:  01 June 2008

Alain Fraisse*
Cardiologie Pédiatrique, Département de Cardiologie, Hôpital La Timone, Marseille, France
Jean Losay
Centre Chirurgical Marie-Lannelongue, Le Plessis Robinson, France
François Bourlon
Centre Cardiothoracique de Monaco, Monaco, Paris, France
Gabriella Agnoletti
Service de Cardiologie Pédiatrique, Hôpital Necker-Enfants-Malades, Paris, France
Jean-René Lusson
Service de Cardiologie et Maladies Vasculaires, CHU Clermont-Ferrand, Hôpital G Montpied, Clermont-Ferrand, France
François Godart
Service des Maladies Cardiovasculaires Infantiles et Congénitales, Hôpital Cardiologique, CHRU de Lille, Lille, France
Bernard De Geeter
Service de Cardiologie, Clinique Sainte Odile, Strasbourg, France
Jérôme Petit
Centre Chirurgical Marie-Lannelongue, Le Plessis Robinson, France
Jean François Piechaud
Institut Cardiovasculaire Paris Sud, Institut Hospitalier Jacques Quartier, Massy, France
Correspondence to: Alain Fraisse, Cardiologie Pédiatrique, Département de Cardiologie, Hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille, France. Tel: (33) 491 38 67 50; Fax: (33) 491 38 56 38; E-mail:



We report the multicentric French experience with transcatheter closure in children weighing 15 kilograms or less, with the aim of assessing the efficacy of the procedure in this age group.


We included all children weighing 15 kilograms or less, and seen between January, 1997, and June, 2004, who had successful transcatheter closure of an interatrial communication within the oval fossa.


Transcatheter closure was performed in 35 patients weighing 15 kilograms or less, of whom 14 were male and 21 female. The procedures were undertaken in 8 different centres, the patients having a median age of 3 years, with a range from zero to 6.2 years, and a mean weight of 13 kilograms, with a range from 3.6 to 15 kilograms. All the patients were symptomatic, with associated cardiac malformations present in 4 cases, and extracardiac anomalies in 4 patients, including Down’s syndrome in 3, and Adams Oliver syndrome in the other case. In 1 patient, emergency cardiac surgery was needed 24 h after the procedure to correct a previously undiagnosed divided right atrium. No other complication occurred. After a median follow-up of 2 years, with a range from 0.5 to 5.2 years, all the patients are asymptomatic, except for one long-standing patient with bronchodysplasia. In 1 other patient, a small residual bidirectional shunt was detected by echocardiography. No patient presented significant arrhythmia. In the patients followed-up for more than 12 months, we found a significant gain in weight gain.


Transcatheter closure of an interatrial communication within the oval fossa is efficient in children weighing 15 kilograms or less, and can be proposed as a first line of treatment in symptomatic patients. Children with retarded growth tend to have complete recovery within one year of closure.

Original Article
Copyright © Cambridge University Press 2008

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